As medical and hospital costs continue to increase, surgeons are constantly striving to develop advanced surgical techniques. Advances in the surgical field are often related to the development of operative techniques that involve less invasive surgical procedures and reduce overall patient trauma. In this manner, the length of hospital stays can be significantly reduced, and therefore the hospital and medical costs can be reduced as well.
One of the truly great advances in recent years to reduce the invasiveness of surgical procedures is endoscopic surgery. Endoscopic surgery involves the use of an endoscope, which is an instrument permitting the visual inspection and magnification of a body cavity. The endoscope is inserted through a cannula after puncture through the wall of the body cavity with a trocar assembly that includes a sharp-pointed obturator. The surgeon can then perform diagnostic and therapeutic procedures at the surgical site with the aid of specialized instrumentation designed to fit through additional trocars providing small diameter openings into the desired body cavity as may be required.
An age-old procedure that surgeons are required to perform to repair or reconstruct traumatized body tissue is suturing. Fortunately, medical instruments have been recently designed to allow a surgeon to manipulate a suture, or suture and needle combination, through the small diameter opening of a cannula. However, the ability to tie an appropriately placed suture knot has become troublesome and problematical.
It is known to use hemostatic clips and clip appliers to ligate blood vessels and other tubular members. Such hemostatic clips and clip appliers are described, for example, in U.S. Pat. Nos. 4,418,694, 4,476,865 and 5,030,226.
In View of the deficiencies of the prior art for creating a useful alternative to tying a suture knot, what is desired within the medical community is a device suitable for application using endoscopic techniques that can successfully replace the suture knot. More specifically, what is needed is a surgical clip and clip applier system particularly adapted for replacing a suture knot during endoscopic surgery and which exhibits adequate clamping force to function effectively.
A surgical clip particularly adapted for use with the present invention is disclosed in commonly assigned U.S. patent application Ser. No. 717,297, filed on Jun. 18, 1991, by C. Chen et al. In order to more readily apply a surgical clip using endoscopic techniques, it is desired to provide an improved cartridge for holding such surgical clips, and an improved surgical clip applier that is insertable into the cartridge for grasping and removing such surgical clips and is then insertable through a trocar tube for applying such surgical clips during endoscopic surgery. In particular, what is needed is an improvement in surgical clip cartridges and appliers that are designed to handle and apply the recently-developed surgical clip having opposed, hinged leg portions which are movable between an open position and a closed position.